Active NPI
Julie Ann Jarvis, DDS
- Dentist
- Mishawaka, IN
National Provider Identifier
1801933759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12010086A
- Practice address
- 54665 Windingbrook Dr
Mishawaka, IN 46545-1545 - Phone
- (574) 520-0098
- NPI assigned
- Jan 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12010086A | IN | Primary |
Addresses
Primary practice location
54665 Windingbrook Dr
Mishawaka, IN 46545-1545
Mailing address
54665 Windingbrook Dr
Mishawaka, IN 46545-1545
Phone (574) 234-1700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010086A | IN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347840000000",
"number": "1801933759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54665 WINDINGBROOK DR",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465451545",
"telephone_number": "574-234-1700",
"fax_number": "574-287-6453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54665 WINDINGBROOK DR",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465451545",
"telephone_number": "574-520-0098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVIS",
"first_name": "JULIE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2012-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12010086A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.